Chronic asthma, a worrying update

Eosinophil activity is associated with allergy and allergic reaction or invasion by parasites
Neutrophiles are associated with defending tissue from harm or infection

Traditionally asthma has been mainly associated with allergy, however, recent research on the new sophisticated anti-allergy drug Xolair, has found that not all symptoms of asthma are allergy related. From these results doctors now speculate that allergy accounts for about half of all symptoms. To emphasise this, they point out that 70% of adult 'late-onset' asthma is not allergy based. This means that patients, who are clinically tested and confirmed to be allergic to specific allergens can no longer be confident that their asthma symptoms are caused by exposure to these allergens. Something else is happening in asthma.

Many doctors believe it is the activity of invading neutrophiles. These are the cells designed to protect vulnerable lungs which are under attack, under repair or hindered by chronic inflammation. They believe the activity of these cells may actually prolong asthma symptoms. Neutrophiles, once activated by stimuli discharge enzymes that cause tissue damage resulting in increased inflammation. The most important of these enzymes is elastase. Recent research, funded by a major UK medical charity, describes how the major house dust mite allergen Der p1 downgrades a regulator specifically designed to dampens down the harm caused by elastase.

If the Charity's doctors are proven to be right, then the whole of asthma management must be reviewed. It may no longer be appropriate for patients to rely upon drugs that artificially open airways in harmful environments in order to prevent wheezing or coughing. Exposure to known risks can encourage neutrophil proliferation and the damaging non-allergy inflammatory activity that follows. (11,12,13,14)